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Hypertension:
An Overview
Hypertension
(High Blood Pressure) It's Important To Know About High Blood
Pressure
High Blood Pressure, also called hypertension, is a risk factor for
heart and kidney diseases and stroke. This means that having high blood
pressure increases your chance (or risk) of getting heart or kidney
disease, or of having a stroke. This is serious business: heart disease
is the number one killer in the United States, and stroke is the third
most common cause of death.
About one in every four American adults has high blood pressure. High
blood pressure is especially dangerous because it often gives no warning
signs or symptoms. Fortunately, though, you can find out if you have
high blood pressure by having your blood pressure checked regularly. If
it is high, you can take steps to lower it. Just as important, if
your blood pressure is normal, you can learn how to keep it from
becoming high.
What Is Blood Pressure — And What Happens When It is High?
Since blood is carried from the heart to all of your body's tissue
and organs in vessels called arteries, blood pressure is the force of
the blood pushing against the walls of those arteries. In fact, each
time the heart beats (about 60-70 times a minute at rest), it pumps out
blood into the arteries. Your blood pressure is at its greatest when the
heart contracts and is pumping the blood. This is called systolic
pressure. When the heart is at rest, in between beats, your blood
pressure falls. This is the diastolic pressure.
Blood pressure is always given as these two numbers, systolic and
diastolic pressures. Both are important. Usually they are written one
above or before the other, such as 120/80 mm Hg, with the top number the
systolic, and the bottom the diastolic. Different actions make your
blood pressure go up or down. For example, if you run for a bus, your
blood pressure goes up. When you sleep at night, your blood pressure
goes down. These changes in blood pressure are normal.
Some people have blood pressure that stays up all or most of the
time. Their blood pushes against the walls of their arteries with
higher-than-normal force. If untreated this can lead to serious medical
problems like these:
- Arteriosclerosis("hardening of the arteries").
High blood pressure harms the arteries by making them thick and
stiff. This speeds the build up of cholesterol and fats in the blood
vessels like rust in a pipe, which prevents the blood from flowing
through the body, and in time can lead to a heart attack or stroke.
- Heart Attack. Blood carries oxygen to the body. When the
arteries that bring blood to the heart muscle become blocked, the
heart cannot get enough oxygen. Reduced blood flow can cause chest
pain (angina). Eventually, the flow may be stopped completely,
causing a heart attack.
- Enlarged heart. High blood pressure causes the heart to
work harder. Over time, this causes the heart to thicken and
stretch. Eventually the heart fails to function normally causing
fluids to back up into the lungs. Controlling high blood pressure
can prevent this from happening.
- Kidney Damage. The kidney acts as a filter to rid the body
of wastes. Over a number of years, high blood pressure can narrow
and thicken the blood vessels of the kidney. The kidney filters less
fluid, and waste builds up in the blood. The kidneys may fail
altogether. When this happens, medical treatment (dialysis) or a
kidney transplant may be needed.
- Stroke. High blood pressure can harm the arteries, causing
them to narrow faster. So, less blood can get to the brain. If a
blood clot blocks one of the narrowed arteries, a stroke (thrombotic
stroke) may occur. A stroke can also occur when very high pressure
causes a break in a weakened blood vessel in the brain (hemorrhagic
stroke).
Who's Likely To Develop High Blood Pressure?
Anyone can develop high blood pressure, but some people are more
likely to develop it than others. For example, high blood pressure is
more common—it develops earlier and is more severe—in
African-Americans than in whites. In the early and middle adult years,
men have high blood pressure more often than women. But as men and women
age, the reverse is true. More women after menopause have high blood
pressure than men of the same age. And the number of both men and
women with high blood pressure increases rapidly in older age groups.
More than half of all Americans over age 65 have high blood pressure.
And older African-American women who live in the Southeast are more
likely to have high blood pressure than those in other regions of the
United States. In fact, the southeastern states have some of the highest
rates of death from stroke. High blood pressure is the key risk factor
for stroke. Other risk factors include cigarette smoking and overweight.
These 11 states—Alabama, Arkansas, Georgia, Indiana, Kentucky,
Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and
Virginia—have such high rates of stroke among persons of all races and
in both sexes that they are called the "Stroke Belt States."
Finally, heredity can make some families more likely than others to
get high blood pressure. If your parents or grandparents had high blood
pressure, your risk may be increased. While it is mainly a disease of
adults, high blood pressure can occur in children as well. Even if
everyone is healthy, be sure you and your family get your blood pressure
checked. Remember, high blood pressure has no signs or symptoms.
How Is Blood Pressure Checked?
Having your blood pressure checked is quick, easy, and painless. Your
blood pressure is measured with an instrument called a sphygmomanometer
(sfig-mo-ma-nom-e-ter). It works like this: A blood pressure cuff is
wrapped around your upper arm and inflated to stop the blood flow in
your artery for a few seconds. A valve is opened and air is then
released from the cuff and the sounds of your blood rushing through an
artery are heard through a stethoscope. The first sound heard and
registered on the gauge or mercury column is called the systolic blood
pressure. It represents the maximum pressure in the artery produced as
the heart contracts and the blood begins to flow. The last sound heard
as more air is released from the cuff is the diastolic blood
pressure. It represents the lowest pressure that remains within the
artery when the heart is at rest.
What Do the Numbers Mean?
Blood pressure is always expressed in two numbers that represent the
systolic and diastolic pressures. These numbers are measurements of
millimeters (mm) of mercury (Hg). The measurement is written one above
or before the other, with the systolic number on the top and the
diastolic number on the bottom. For example, a blood pressure
measurement of 120/80 mm Hg is expressed verbally as "120 over
80." See the following table, which shows categories for blood
pressure levels in adults. If your blood pressure is less than 140/90 mm
Hg, it is considered normal. However, a blood pressure below 120/80 mm
Hg is even better for your heart and blood vessels. People use to think
that low blood pressure (for example, 105/65 mm Hg in an adult) was
unhealthy. Except for rare cases, this is not true. High blood pressure
or "hypertension" is classified by stages and is more serious
as the numbers get higher.
CATEGORIES FOR BLOOD PRESSURE LEVELS IN ADULTS
(Age 18 Years and Older)
| |
Blood
Pressure Level (mm Hg) |
|
Category
|
Systolic |
Diastolic |
| Normal |
<130 |
<85 |
| High
Normal |
130-139 |
85-89 |
| High
Blood Pressure |
| Stage
1 |
140-159 |
90-99 |
| Stage
2 |
160-179 |
100-109 |
| Stage
3 |
>180 |
>110
|
| *For
those not taking medicine for high blood pressure and not having
a short-term serious illness. These categories are from the
National High Blood Pressure Education Program.
(< means less than | > means greater
than or equal to)
|
1.6
What Causes High Blood Pressure?
For most people, there is no single known cause of high blood
pressure. This type of high blood pressure is called "primary"
or "essential" hypertension. This type of blood pressure can't
be cured, although in most cases it can be controlled. That's why it's
so important for everyone to take steps to reduce their chances of
developing high blood pressure. In a few people, high blood pressure can
be traced to a known cause like tumors of the adrenal gland, chronic
kidney disease, hormone abnormalities, use of birth control pills, or
pregnancy. This is called "secondary hypertension." Secondary
hypertension is usually cured if its cause passes or is corrected.
How Can You Prevent High Blood Pressure?
Everyone—regardless of race, age, sex, or heredity—can help lower
his/her chance of developing high blood pressure. Here's how:
- Maintain a healthy weight, lose weight if you are overweight
- Be more physically active
- Choose foods lower in salt and sodium
- If you drink alcoholic beverages, do so in moderation
These rules are also recommended for treating high blood pressure,
although medicine is often added as part of the treatment. It is far
better to keep your blood pressure from getting high in the first place.
Another important measure for your health is to not smoke: while
cigarette smoking is not directly related to high blood pressure, it
increases your risk of heart attack and stroke.
Let's look more closely at the four rules to prevent high blood
pressure and for keeping a healthy heart:
Maintain a healthy weight, lose weight if you are overweight.
As your body weight increases, your blood pressure rises. In fact,
being overweight can make you two to six times more likely to develop
high blood pressure than if you are at your desirable weight. Keeping
your weight in the desirable range is not only important to prevent high
blood pressure but also for your overall health and well-being. It's not
just how much you weigh that's important: it also matters where
your body stores extra fat. Your shape is inherited from your
parents just like the color of your eyes or hair. Some people tend to
gain weight around their belly; others, around the hips and thighs.
"Apple-shaped" people who have a pot belly (that is, extra fat
at the waist) appear to have higher health risks than
"pear-shaped" people with heavy hips and thighs.
No matter where the extra weight is, you can reduce your risk of high
blood pressure by losing weight. Even small amounts of weight loss can
make a big difference in helping to prevent high blood pressure. Losing
weight, if you are overweight and already have high blood pressure, can
also help lower your pressure. To lose weight, you need to eat fewer
calories than you burn. But don't go on a crash diet to see how
quickly you can lose those pounds. The healthiest and longest-lasting
weight loss happens when you do it slowly, losing 1/2 to 1 pound a week.
By cutting back by 500 calories a day by eating less and being more
physically active, you can lose about 1 pound (which equals 3,500
calories) in a week.
Losing weight and keeping it off involves a new way of eating and
increasing physical activity for life. Here's how to eat and get on your
way to a lower weight:
Choose foods low in calories and fat. Naturally, choosing
low-calorie foods cuts calories. But did you know that choosing foods
low in fat also cuts calories? Fat is a concentrated source of calories,
so eating fewer fatty foods will reduce calorie intake. Some examples of
fatty foods to cut down on are: butter, margarine, regular salad
dressings, fatty meats, skin of poultry, whole milk dairy foods like
cheese, fried foods, and many cookies, cakes, pastries and snacks. See
the table below for low fat foods that you can enjoy instead.
TRY THESE LOW FAT FOODS
| Baked,
broiled or poached: chicken and turkey (without the skin); fish;
lean cuts of meat (like round or sirloin). |
| Skim,
1%, or evaporated skim milk and lower-fat, low-sodium cheeses. |
| Fresh,
frozen, or canned fruit. |
| Fresh,
frozen, or canned (no salt added) vegetables (without cream or
cheese sauces). |
| Plain
rice and pasta, English muffins, bagels, sandwich breads and
rolls, and soft tortillas. |
| Cold
ready-to-eat) cereals, lower in sodium and cooked hot cereals
(not instant since they are higher in sodium). |
| Note:
When choosing cheeses, breads, and cereals, use the food label
to choose those lower in fat and sodium. |
Choose
foods high in starch and fiber. Foods high in starch and fiber, like
those shown in the table, are excellent substitutes for foods high in
fat. They are lower in calories than foods high in fat. These foods are
also good sources of vitamins and minerals.
FOODS HIGH IN STARCH AND/OR FIBER
| Fruits,
vegetables, whole-grain cereals, pasta and rice, whole-grain
breads, dry peas and beans. |
| Note:
Use the food label to choose breads and cereals lower in sodium. |
Limit serving sizes. To lose weight, it's not just the type
of foods you eat that's important, but also the amount . To take
in fewer calories, you need to limit your portion sizes. Try especially
to take smaller helpings of high calorie foods like high fat meats and
cheeses. And try not to go back for seconds. Here's a good tip to help
you control or change your eating habits: keep track of what you eat,
when you eat, and why, by writing it down. Note whether you snack on
high fat foods in front of the television, or if you skip breakfast and
then eat a large lunch. Once you see your habits, you can set goals for
yourself: cut back on TV snacks and, when you do snack, have fresh
fruit, unsalted air-popped popcorn, or unsalted pretzels. If there's no
time for breakfast at home, take a low fat muffin, bagel (skip the cream
cheese), or cereal with you to eat at work. Changing your behavior will
help you change your weight for the better.
Increase physical activity. There's more to weight loss than
just eating less. Another important ingredient is increasing physical
activity, which burns calories. Cutting down on fat and calories
combined with regular physical activity can help you lose more weight
and keep it off longer than either way by itself. Check the table below
to see how many calories you can burn during different activities.
CALORIES BURNED DURING PHYSICAL ACTIVITIES
| Activity |
Calories
Burned Up Per Hour* |
| |
Man** |
Woman
** |
| Light
Activity: |
300 |
240 |
| Cleaning
house |
|
|
| Playing
baseball |
|
|
| Playing
golf |
|
|
| Moderate
activity: |
460 |
370 |
| Walking
briskly (3.5 mph) |
|
|
| Gardening |
|
|
| Cycling
(5.5 mph) |
|
|
| Dancing |
|
|
| Playing
basketball |
|
|
| Strenuous
activity: |
730 |
580 |
| Jogging
(9 min./mile) |
|
|
| Playing
football |
|
|
| Swimming |
|
|
| Very
strenuous activity: |
920 |
740 |
| Running
(7 min./mile) |
|
|
| Racquetball |
|
|
| Skiing |
|
|
*May vary depending on a variety of factors including environmental
conditions.
** Healthy man, 175 pounds; healthy woman 140 pounds.
Source: Dietary Guidelines for Americans, U.S. Department of
Agriculture, U.S. Department of Health and Human Services, Third
edition, 1990 (adapted from McArdle, et al., "Exercise Physiology,
" 1986).
Be More Physically Active.
Besides losing weight, there are other reasons to be more active:
being physically active can reduce your risk for heart disease, help
lower your total cholesterol level and raise HDL-cholesterol (the
"good" cholesterol that does not build up in the arteries),
and help lower high blood pressure. And people who are physically active
have a lower risk of getting high blood pressure—20 to 50 percent
lower—than people who are not active. You don't have to be a marathon
runner to benefit from physical activity. Even light activities, if done
daily, can help lower your risk of heart disease. So you can fit
physical activity into your daily routine in small but important ways.
Steps you can take to be more physically active:
- Use the stairs instead of the elevator.
- Get off the bus one or two stops early and walk the rest of the
way.
- Park farther away from the store or office.
- Ride a bike.
- Work in the yard or garden.
- Go dancing.
More vigorous exercise has added benefits. It helps improve the
fitness of the heart and lungs. And that in turn protects you more
against heart disease. Activities like swimming, brisk walking, running,
and jumping rope are called "aerobic." This means that the
body uses oxygen to make the energy it needs for the activity. Aerobic
activities can condition your heart and lungs if done at the right
intensity for at least 30 minutes, three to four times a week. But if
you don't have 30 minutes for a break, try to find two 15-minute periods
or even three 10-minute periods. Try to do some type of aerobic activity
in the course of a week.
Most people don't need to see a doctor before they start exercising,
since a gradual, sensible exercise program has few health risks. But if
you have a health problem like high blood pressure; if you have pains or
pressure in the chest or shoulder area; if you tend to feel dizzy or
faint; if you get very breathless after a mild workout; or are
middle-age or older and have not been active, and you are planning a
vigorous exercise program, you should check with your doctor first.
Otherwise, get out, get active, and get fit—and help prevent high
bloodpressure. The sample walking program at the end of this fact sheet
can help you get started.
Choose Foods Lower in Salt and Sodium.
Americans eat more salt (sodium chloride) and other forms of sodium
than they need. And guess what? They also have higher rates of high
blood pressure than people in other countries who eat less salt. Often,
if people with high blood pressure cut back on salt and sodium, their
blood pressure falls. Cutting back on salt and sodium also prevents
blood pressure from rising. Some people like African-Americans and the
elderly are more affected by sodium than others. Since there's really no
practical way to predict exactly who will be affected by sodium, it
makes sense to limit intake of salt and sodium to help prevent high
blood pressure.
All Americans, especially people with high blood pressure, should eat
no more than about 6 grams of salt a day, which equals about 2,400
milligrams of sodium. That's about 1 teaspoon of table salt. But
remember to keep track of ALL salt eaten—including that in
processed foods and added during cooking or at the table. Americans eat
4,000 to 6,000 milligrams of sodium a day, so most people need to cut
back on salt and sodium. See the list below for the range of sodium in
some types of foods.
Quantity of Sodium in Various Foods (In Milligrams)
MEAT, POULTRY, FISH, AND SHELLFISH
- Fresh meat (including lean cuts of beef, pork, lamb and veal)
poultry, finfish, cooked, 3 oz. (less than 90)
- Shellfish, 3 oz. (100-325)
- Tuna, canned, 3 oz (300)
- * Sausage, 2 oz. (515)
- * Bologna, 2 oz. (535)
- * Frankfurter, 1-1/2 oz. (560)
- Boiled ham, 2 oz. (750)
- Lean ham, 3 oz. (1,025)
EGGS
- Egg white, 1 (55)
- * Whole egg, 1 (65)
- Egg substitute, 1/4 cup = 1 egg (80-120)
DAIRY PRODUCTS
Milk
- * Whole milk, 1 cup (120)
- Skim or 1% milk, 1 cup (125)
- Buttermilk (salt added), 1 cup (260)
Cheese
- * Natural Cheese:
- * Swiss Cheese, 1 oz. (75)
- * Cheddar cheese, 1 oz. (175)
- * Blue Cheese, 1 oz. (395)
- Low fat cheese, 1 oz. (150)
- * Process cheese and cheese spreads, 1 oz. (340-450)
- Lower sodium and fat versions (read the label)
- * Cottage cheese (regular), 1/2 cup (455)
- Cottage cheese (low fat), 1/2 cup (460)
Yogurt
- * Yogurt, whole milk, plain, 8 oz. (105)
- Yogurt, fruited or flavored, low fat or nonfat, 8 oz. (120-150)
- Yogurt, nonfat or low fat, plain, 8 oz. (160-175)
VEGETABLES
- Fresh or frozen vegetables, or no salt added canned (cooked
without salt), 1/2 cup (less than 70)
- Vegetables, canned, no sauce, 1/2 cup (55-470)
- * Vegetables, canned or frozen with sauce, 1/2 cup (read the
label)
- Tomato juice, canned, 3/4 cup (660)
BREADS, CEREALS, RICE, PASTA, DRY PEAS AND BEANS
Breads and Crackers
- Bread, 1 slice (110-175)
- English muffin, 1/2 (130)
- Bagel, 1/2 (190)
- Cracker, saltine type, 5 squares (195)
- * Baking powder biscuit, 1 (305)
Cereals (Ready-to-eat)
- Shredded wheat, 3/4 cup (less than 5)
- Puffed wheat and rice cereals, 1-1/2 to 1-2/3 cup (less than 5)
- Granola-type cereals, 1/2 cup (5-25)
- Ring and nugget cereals, 1 cup (170-310)
- Flaked cereals, 2/3 to 1 cup (170-360)
Cereals (Cooked)
- Cooked cereal (unsalted) 1/2 cup (less than 5)
- Instant cooked cereal, 1 packet=3/4 cup (180)
Pasta and rice
- Cooked rice and pasta (unsalted) 1/2 cup (less than 10)
- * Flavored rice mix, cooked, 1/2 cup (250-390)
Peas and beans
- Peanut butter (unsalted) 2 tbsp. (less than 5)
- Peanut butter, 2 tbsp. (150)
- Dry beans, home cooked (unsalted), or no salt added canned, 1/2
cup (less than 5)
- Dry beans, plain, canned, 1/2 cup (350-590)
- * Dry beans, canned with added fat or meat, 1/2 cup (425-630)
FRUITS
- Fruits (fresh, frozen, canned), 1/2 cup (less than 10)
FATS AND OILS
- Oil, 1 tbsp. (0)
- * Butter (unsalted), 1 tsp. (1)
- * Butter (salted),1 tsp (25)
- Margarine (unsalted), 1 tsp. (less than 5)
- Margarine (salted), 1 tsp. (50)
- Imitation mayonnaise, 1 tbsp. (75)
- * Mayonnaise, 1 tbsp. (80)
- Prepared salad dressings, low calorie, 2 tbsp. (50-310)
- * Prepared salad dressings, 2 tbsp. (210-440)
SNACKS
Popcorn, chips, and nuts
- Unsalted nuts, 1/4 cup (less than 5)
- Salted nuts, 1/4 cup (185)
- * Unsalted potato chips and corn chips, 1 cup (less than 5)
- * Salted potato chips and corn chips, 1 cup (170-285)
- Unsalted popcorn, 2 1/2 cups (less than 10)
- Salted popcorn, 2 1/2 cups (330)
Candy
- Jelly beans, 10 large (5)
- * Milk chocolate bar, 1 oz. Bar (25)
Frozen desserts
- * Ice cream, 1/2 cup (35-50)
- Frozen yogurt, low fat or nonfat, 1/2 cup (40-55)
- Ice milk, 1/2 cup (55-60)
CONDIMENTS
- Mustard, chili sauce, hot sauce, 1 tsp. (35-65)
- Catsup, steak sauce, 1 tbsp. (100-230)
- Salsa, tartar sauce, 2 tbsp. (85-205)
- Salt, 1/6 tsp. (390)
- Pickles, 5 slices (280-460)
- Soy sauce, lower sodium, 1 tbsp. (600)
- Soy sauce, 1 tbsp. (1030)
CONVENIENCE FOODS
- ** Canned and dehydrated soups, 1 cup (600-1,300)
- ** Lower sodium versions (read the label)
- *** Canned and frozen main dishes, 8 oz. (500-1,570)
- *** Lower sodium versions (read the label)
- * Choices are higher in saturated fat, cholesterol, or both.
- ** Creamy soups are higher in saturated fat and cholesterol.
- *** Limit main dishes that have ingredients higher in saturated
fat, cholesterol, or both.
Source: Adapted from Home and Garden Bulletin 253-7, United States
Department of Agriculture, July 1993.
You can teach your taste buds to enjoy less salty foods. Here are a
few tips:
- Check food labels for the amount of sodium in foods. Choose
those lower in sodium most of the time. Look for products that say
"sodium free," "very low sodium," "low
sodium," "light in sodium," "reduced or less
sodium," or "unsalted," especially on cans, boxes,
bottles, and bags.
- Buy fresh, plain frozen, or canned with "no salt added
" vegetables. Use fresh poultry, fish and lean meat, rather
than canned or processed types.
- Use herbs, spices, and salt-free seasoning blends in
cooking and at the table instead of salt.
- Cook rice, pasta, and hot cereals without salt. Cut back on
instant or flavored rice, pasta, and cereal mixes because they
usually have added salt.
- Choose "convenience" foods that are lower in sodium. Cut
back on frozen dinners, mixed dishes like pizza, packaged mixes,
canned soups or broths, and salad dressings which often have a lot
of sodium.
- When available, buy low-or reduced-sodium, or
"no-salt-added" versions of foods.
- Rinse canned foods like tuna to remove some sodium.
If You Drink Alcoholic Beverages, Do So In Moderation.
Drinking too much alcohol can raise your blood pressure. It may also
lead to the development of high blood pressure. So to help prevent high
blood pressure, if you drink alcohol, limit how much you drink to no
more than 2 drinks a day. The "Dietary Guidelines for
Americans" recommend that for overall health women should limit
their alcohol to no more than 1 drink a day.
This is what counts as a drink:
- 1-1/2 ounces of 80-proof or 1 ounce of 100-proof whiskey
- 5 ounces of wine, or 12 ounces of beer (regular or light)
You may have heard that some alcohol is good for your heart health.
Some news reports suggest that people who consume a drink or two a day
have lower blood pressure and live longer than those who consume
excessive amounts of alcohol. Others note that wine raises the
"good" blood cholesterol that prevents the build up of fats in
the arteries. While these news stories may be correct they don't tell
the whole story: too much alcohol contributes to a host of other health
problems, such as motor vehicle accidents, diseases of the liver and
pancreas, damage to the brain and heart, an increased risk of many
cancers, and fetal alcohol syndrome.
Alcohol is also high in calories. So you should limit how much you
drink.
What Else Might Prevent High Blood Pressure?
Other things also may help prevent blood pressure. Here's a roundup
of what's being said about them-and whether it's true or false.
Dietary Supplements—Potassium, Calcium, Magnesium, Fish Oils.
Potassium. Eating foods rich in potassium will help protect
some people from developing high blood pressure. You probably can get
enough potassium from your diet, so a supplement isn't necessary. Many
fruits, vegetables, dairy foods, and fish are good sources of potassium.
Calcium. Populations with low calcium intakes have high rates
of high blood pressure. However, it has not been proven that taking
calcium tablets will prevent high blood pressure. But it is important to
be sure to get at least the recommended amount of calcium—800
milligrams per day for adults (pregnant and breastfeeding women need
more) — from the foods you eat. Dairy foods like low fat selections of
milk, yogurt, and cheese are good sources of calcium. Low fat and nonfat
dairy products have even more calcium than the high fat types.
Magnesium. A diet low in magnesium may make your blood
pressure rise. But doctors don't recommend taking extra magnesium to
help prevent high blood pressure—the amount you get in a healthy diet
is enough. Magnesium is found in whole grains, green leafy vegetables,
nuts, seeds, and dry peas and beans. '
Fish oils. A type of fat called "omega-3 fatty
acids" is found in fatty fish like mackerel and salmon. Large
amounts of fish oils may help reduce high blood pressure, but their role
in prevention is unclear. But taking fish oil pills is not recommended
because high doses can cause unpleasant side effects. The pills are also
high in fat and calories. Of course, most fish if not fried or made with
added fat are low in saturated fat and calories and can be eaten often.
Other Factors
Fats, Carbohydrates, and Protein. Varying the amount and type
of fats, carbohydrates, and protein in the diet has little, if any,
effect on blood pressure. But for overall heart health, it is crucial to
limit the amount of fat in your diet, especially the saturated fat found
in foods like fatty meats and whole milk dairy foods. Saturated fats
raise your blood cholesterol level, and a high blood cholesterol level
is another risk factor for heart disease. Foods high in fat are also
high in calories. Remember, foods high in complex carbohydrate (starch
and fiber) are low in fat and calories—so eating these foods in
moderate amounts instead of high fat foods can help you to lose weight
if you are overweight or to prevent you from gaining weight.
Caffeine. The caffeine in drinks like coffee, tea, and sodas
may cause blood pressure to go up, but only temporarily. In a short time
your blood pressure will go back down. Unless you are sensitive to
caffeine and your blood pressure does not go down, you do not have to
limit caffeine to prevent developing high blood pressure.
Garlic or Onions. Increased amount of garlic and onions have
not been found to affect blood pressure. Of course, they are tasty
substitutes for salty seasonings and can be used often.
Stress Management. Stress can make blood pressure go up for a
while and over time may contribute to the cause of high blood pressure.
So it's natural to think that stress management techniques like
biofeedback, meditation, and relaxation would help prevent high blood
pressure. But this doesn't seem to be the case: the few studies that
have looked at this have not shown that stress management helps to
prevent high blood pressure. Of course, stress management techniques are
helpful if they help you feel better or stick to a weight-loss and/or
exercise program.
Blood Pressure Medications
The main types of high blood pressure drugs are:
Diuretics — These are sometimes called "water
pills" because they work in the kidney and flush excess water and
sodium from the body through urine. This reduces the amount of fluid in
the blood. And, since sodium is flushed out of blood vessel walls, the
vessels open wider. Pressure goes down. There are different types of
diuretics. They are often used with other high blood pressure drugs.
Beta blockers — These reduce nerve impulses to the heart and
blood vessels. This makes the heart beat less often and with less force.
Blood pressure drops and the heart works less hard.
Angiotensin antagonists — These are a new type of high blood
pressure drug. They shield blood vessels from a hormone called
angiotensin II, which normally causes vessels to narrow. As a result,
the vessels are wider and pressure lowers.
Angiotensin converting enzyme (ACE) inhibitors—These prevent
angiotensin II from being formed. They relax blood vessels and pressure
goes down.
Calcium channel blockers (CCBs) — These keep calcium from
entering the muscle cells of the heart and blood vessels. Blood vessels
relax and pressure goes down. One short-acting type of CCB has been
found to increase the chance of a repeat heart attack. Short-acting CCBs
are taken several times a day. If you are on such a drug, you should
talk with your doctor about other medication choices. The finding does
not apply to the longer-acting types of CCB, which are taken once a day.
Alpha blockers — These work on the nervous system to relax
blood vessels, which allows blood to pass more easily.
Alpha-beta blockers — These work the same way as alpha
blockers but also slow the heartbeat, as beta-blockers do. As a result,
less blood is pumped through the vessels.
Nervous system inhibitors — These relax blood vessels by
controlling nerve impulses.
Vasodilators — These open blood vessels by relaxing the
muscle in the vessel walls.
Review
After going through all the things that may affect blood
pressure, it's worth noting again the things that are sure to
help you prevent high blood pressure:
- Maintaining a healthy weight—losing weight if you are overweight
- Being more physically active
- Choosing foods low in salt and sodium
- If you drink alcoholic beverages, doing so in moderation.
By following these guidelines, you can help reduce or prevent high
blood pressure for life—and, in turn, lower your risk for heart
disease and stroke.
If you smoke, stop
Smoking usually does not affect blood pressure. But quitting is the
most important step you can take for your health. Ask your doctor for
advice on how to quit.
If You Have Diabetes
In diabetes mellitus, the body does not use sugar as it should. It
gets sugar when it changes food into glucose, a form of sugar. Two main
types of diabetes are non-insulin-dependent (NIDDM) and
insulin-dependent (IDDM).
NIDDM accounts for 90-95 percent of diabetes. It usually develops
after age 40. About 80 percent of those with NIDDM are overweight. NIDDM
often can be controlled through diet and exercise, but sometimes insulin
and/or a pill are needed. IDDM is controlled by diet and exercise and
taking insulin.
Diabetes is a chronic condition. If you have it, you’re more likely
to have certain health problems than women without it. You’re 2 to 4
times more likely to develop cardiovascular disease, and 2.5 times more
likely to have a stroke. As many as 65 percent of those with diabetes
have high blood pressure.
Hold the Salt
Here are some tips to help you cut back on salt and sodium:
- Add less salt at the table and in cooking. Try reducing the amount
a little at a time until you use none.
- Season with black or green pepper, garlic, ginger, minced onion,
or lemon juice.
- Use fewer prepared sauces, mixes, and “instant” products, such
as flavored rices, pasta, and cereals. These usually have salt
added.
- Use vegetables that are fresh, frozen, or canned without added
salt.
- Check nutrition labels for a product’s amount of sodium. Cans,
boxes, bottles, and bags have these labels. Look for products that
say “sodium free,” “low sodium,” “reduced sodium,”
“less sodium,” “light in sodium,” or “unsalted.”
- Ask your doctor before trying salt substitutes. These contain
potassium chloride and may help some women. But they can be harmful
for women with certain medical conditions.
Sensible Snacks
To help cut back on sodium, snack on:
- Bagels, raisin toast, or English muffins
- Air-popped popcorn with no salt or butter
- Unsalted pretzels and crackers
- Low-fat cookies (animal crackers, fig bars, ginger snaps)
- Fruit juices and drinks
- Nonfat frozen yogurt, sherbet, and popsicles
- Hard candy or jelly beans
A Word About Fats
Scientists are not certain that fats or cholesterol in foods raise
blood pressure. But dietary fats and cholesterol definitely affect your
heart and blood vessels.
Fats, especially saturated fat, play a big role in increasing the
cholesterol in your bloodstream. And that increases your chance of
developing heart disease.
Saturated fat is often found in foods from animals. This includes
fatty meats, the skin of poultry, and whole-milk dairy products, such as
butter, cheese, cream, and ice cream. It also is in coconut, palm
kernel, and palm oils. These oils are found mostly in processed foods,
such as baked goods, snack foods, and crackers. If you use a food high
in saturated fat, keep the amount small. Or, instead of butter, try tub
or liquid margarine, or liquid vegetable oils such as canola, corn,
olive, peanut, safflower, sesame, soybean, and sunflower.
Keep in mind, all fats have the same amount of calories. If you need
to lose weight, limit the amount of fats you consume.
If You Need a High Blood Pressure Drug, Speak Up and Ask:
- When it should be taken
- What you can eat or drink with the drug, or how long you must wait
before and after a meal to take it
- What other drugs can or cannot be used at the same time—this
includes both prescription drugs and over-the-counter items, such as
pain relievers, vitamins, and skin-protection products
- What to do if you run out of your drug
- What to do if you forget to take a dose
- If there are any special instructions.
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